Small business owners are fundamentally pragmatic and don’t care much for political theater, especially on issues that affect commerce on Main Street. So as healthcare reform plays out on the national stage, local merchants just want more affordable healthcare for themselves and their employees.

Nowhere is this more true than Pennsylvania, where 47% of small business owners say Obamacare repeal would have “no impact” on their business, according to a new national study by Womply. That’s significantly higher than the 29% nationally who said repealing the Affordable Care Act wouldn’t affect their business. This is surprising becuase Pennsylvania merchants strongly favored Republican candidate Donald Trump (48%) over Democrat Hillary Clinton (33%) in the 2016 presidential election.

Healthcare looms large for Pennsylvania small businesses, and so is the health of the national and state economies. Despite reports that the state’s SMBs are bullish on sales increasing this year, Pennsylvania’s local businesses are lagging national benchmarks for optimism and hiring intent. The Keystone State ranks #31 nationally for small business optimism, with 4 optimistic owners for every pessimistic one, and #30 for hiring intent, with only 21%planning to add staff this year.

So, optimism is relative, even intrastate. Philadelphia, for example, is on track to continue an upward pattern, according to PNC Financial Services data, whereas Pittsburgh is beset with climbing unemployment. These converging forces offer some insight into our study’s findings about what’s driving confidence and anxiety for Pennsylvania’s small businesses. Read our full report below.